PART III A - QUOTER DOCUMENTS.pdf

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Attached to
Fort Simcoe - Fire Alarm Inspection Services Federal contract opportunity
Solicitation number
1282A722Q0030
Issued by
Department of Agriculture Forest Service

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ATTACHMENT TO SF 1449 - SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS | PAGE OF PAGES Solicitation No 1282A721Q0030 | | IN REFERENCE TO PART III A Quoter Documents _ |__1 |__ 2_____

1. SCHEDULE OF SERVICES:

19.

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

TOTAL AMT

Fire Alarm System Inspections

0001 Fire Alarm Systems Inspections – Multiple Buildings 1 EA $ $

TOTAL $

ATTACHMENT TO SF 1449 - SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS | PAGE OF PAGES Solicitation No 1282A721Q0030 | | IN REFERENCE TO PART III A Quoter Documents _ |__2 |__ 2_____

I. 10. QUOTER’S QUESTIONNAIRE

☐ Completed Schedule of Services with proposed pricing.

☐ Quoter confirms the attached Scope of work has been thoroughly reviewed before submitting a quotation.

☐ The registration process at www.SAM.gov has been successfully completed.

☐ Quoter confirms the provision FAR 52.204-26 and FAR 52.212-3, the annual representations and certifications, has been electronically completed at www.SAM.gov. The complete provision can be found at https://www.acquisition.gov/browse/index/far.

☐ Contract Federal Tax ID Number is provided:__________________________ ☐ Contractor DUNS number is provided:_________________________ ☐ A copy of the applicable State license(s) for the proposed Personnel are provided.

☐ Proof of Insurance, in accordance with FAR 52.228-5 and AGAR 452.228-71 is provided.

Contractor’s Point of Contact (POC) Information is provided:

Name: Company:

Position: Email:

Phone: Fax:

☐ The following questions have been answered as provided below:

1. Within the past 5 years have you failed to complete any work awarded to you or been terminated for default or breach of contract? If yes, explain.

☐ The following three (3) professional references of similar past work performance within the last three (3) years is provided:

1. Name: Organization:

Phone: Email:______________________________________

2. Name: Organization:

Phone: Email:______________________________________

3. Name: Organization:

Phone: Email:

☐ I certify that all of the information provided above is complete, true, and correct to the best of my knowledge.

Sign:______________________________________ Date:_______________________________________ http://www.sam.gov/ http://www.sam.gov/ https://www.acquisition.gov/browse/index/far

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